A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?

Atrial flutter

Atrial fibrillation

Unstable angina

Premature atrial contractions (PACS)

Answer and Explanation

The Correct Answer is B

A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.

B.   Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C.   Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D.   PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.

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Correct Answer is D

Explanation

A. Heparin is an anticoagulant medication used primarily to prevent and treat blood clots. It does not directly affect cardiac output or ejection fraction.
B. Adenosine is used to treat supraventricular tachycardia (SVT) by slowing conduction through the AV node. It does not directly affect cardiac output or ejection fraction in the context of heart failure.
C. Warfarin is an anticoagulant used to prevent blood clots. Similar to heparin, it does not affect cardiac output or ejection fraction.
D. Digoxin is a medication that increases the strength and efficiency of heart contractions (positive inotropic effect) and slows the heart rate (negative chronotropic effect). It is commonly used in heart failure to improve symptoms and increase cardiac output by enhancing the heart's ability to pump blood effectively.

A. Degeneration of nerves in the brainstem and spinal cord. B. Pleural effusion caused by immobility. C. Demyelination of nerves that stimulate the respiratory muscles. D. Bronchoconstriction and edema of the airways.

Correct Answer is C

Explanation

A. While GBS primarily affects peripheral nerves (nerves outside the brain and spinal cord), it does not typically cause direct degeneration of nerves in the brainstem and spinal cord. Therefore, this option is not correct in the context of respiratory distress in GBS.
B. Pleural effusion caused by immobility: Pleural effusion, an accumulation of fluid in the pleural cavity around the lungs, is not a typical complication of GBS. It is more commonly associated with conditions such as heart failure, pneumonia, or malignancy, rather than directly with GBS.
C. In Guillain-Barre Syndrome, demyelination of nerves affects the transmission of signals from the brain to the muscles, including those responsible for respiration. As a result, respiratory muscles may become weak or paralyzed, leading to shallow breathing and respiratory distress.
D. While respiratory distress can occur in some neurological conditions due to autonomic dysfunction or secondary complications, such as aspiration pneumonia, bronchoconstriction and airway edema are not typical manifestations of GBS itself.

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A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing the results of the client's echocardiogram and notes that the ejection fraction is 35%. The nurse anticipates that which of the following medications will be ordered to increase the client's cardiac output?

Correct Answer is D

Explanation

A nurse is assessing a client who has Guillain-Barre Syndrome, and notes that the client's breathing is shallow and the client is short of breath. The nurse understands that that the client's respiratory distress is caused by which of the following?

Correct Answer is C

Explanation

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